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@article{Patel:2022:10.1186/s13063-021-05967-2,
author = {Patel, B and Mumby, S and Johnson, N and Falaschetti, E and Hansen, J and Adcock, I and McAuley, D and Takata, M and Karbing, DS and Jabaudon, M and Schellengowski, P and Rees, SE},
doi = {10.1186/s13063-021-05967-2},
journal = {Trials},
pages = {1--18},
title = {Decision support system to evaluate ventilation in the acute respiratory distress syndrome (DeVENT study)-trial protocol},
url = {http://dx.doi.org/10.1186/s13063-021-05967-2},
volume = {23},
year = {2022}
}

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TY  - JOUR
AB  - BackgroundThe acute respiratory distress syndrome (ARDS) occurs in response to a variety of insults, and mechanical ventilation is life-saving in this setting, but ventilator-induced lung injury can also contribute to the morbidity and mortality in the condition. The Beacon Caresystem is a model-based bedside decision support system using mathematical models tuned to the individual patient’s physiology to advise on appropriate ventilator settings. Personalised approaches using individual patient description may be particularly advantageous in complex patients, including those who are difficult to mechanically ventilate and wean, in particular ARDS.MethodsWe will conduct a multi-centre international randomised, controlled, allocation concealed, open, pragmatic clinical trial to compare mechanical ventilation in ARDS patients following application of the Beacon Caresystem to that of standard routine care to investigate whether use of the system results in a reduction in driving pressure across all severities and phases of ARDS.DiscussionDespite 20 years of clinical trial data showing significant improvements in ARDS mortality through mitigation of ventilator-induced lung injury, there remains a gap in its personalised application at the bedside. Importantly, the protective effects of higher positive end-expiratory pressure (PEEP) were noted only when there were associated decreases in driving pressure. Hence, the pressures set on the ventilator should be determined by the diseased lungs’ pressure-volume relationship which is often unknown or difficult to determine. Knowledge of extent of recruitable lung could improve the ventilator driving pressure. Hence, personalised management demands the application of mechanical ventilation according to the physiological state of the diseased lung at that time. Hence, there is significant rationale for the development of point-of-care clinical decision support systems which help personalise ventilatory strateg
AU  - Patel,B
AU  - Mumby,S
AU  - Johnson,N
AU  - Falaschetti,E
AU  - Hansen,J
AU  - Adcock,I
AU  - McAuley,D
AU  - Takata,M
AU  - Karbing,DS
AU  - Jabaudon,M
AU  - Schellengowski,P
AU  - Rees,SE
DO  - 10.1186/s13063-021-05967-2
EP  - 18
PY  - 2022///
SN  - 1745-6215
SP  - 1
TI  - Decision support system to evaluate ventilation in the acute respiratory distress syndrome (DeVENT study)-trial protocol
T2  - Trials
UR  - http://dx.doi.org/10.1186/s13063-021-05967-2
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000743529200003&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-021-05967-2
UR  - http://hdl.handle.net/10044/1/94218
VL  - 23
ER  -

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